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General NPI Number Information
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NPI Number | 1003038019
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Entity Type | Individual
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Provider Name | MARK ATSUSHI KUJIRAOKA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2821 EASTERN AVENUE SUITE #2
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City | SACRAMENTO
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State | CA
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Zip | 95821
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Country | US
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Telephone | 916-483-7459
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Fax | 916-483-0604
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Provider Business Mailing Address
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Address Line | 11361 SUTTERS MILL CIRCLE
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City | GOLD RIVER
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State | CA
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Zip | 95670
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Country | US
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Telephone | 916-635-0829
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Fax | 916-635-1059
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DB034625
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License Number State | CA
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